Cannabis use by children and teens raises a specter which has long been exploited by opponents of the herb: the nation’s youth seduced into drug dependence, depravity, and slackerdom by a dangerous substance whose use leads inevitably to addiction and harder drugs.

Could it be that many teen cannabis users are simply self-medicating to alleviate undiagnosed anxiety and depression? The prevalence of depression, anxiety and other forms of stress in teens may be considerably greater than is commonly understood. A National Youth Violence Prevention Center survey revealed that 20% of teens had thought about suicide within the past year.

As Tom O’Connell, MD, has pointed out, self-medicating with cannabis for anxiety and depression can be a safer alternative to use of nicotine, alcohol, cocaine, heroin, and other drugs. There are a number of conditions with significant incidence in children and teens—notably asthma, ADD/ADHD, and auto-immune disease—that are amenable to treatment by cannabis. Unfortunately, given the intensity of the political and emotional charge surrounding this issue, the necessary research cannot be carried out.

Joanie: A Teen with Pain

Joanie was 19 when I met her in a clinic. She had been using cannabis for four years. Her mother accompanied her to the clinic, and was obviously very supportive of her use, and positive about what she agreed were dramatic benefits Joanie had experienced. As her story unfolded, I felt a widening disconnect between Joanie’s obvious poise and intelligence, and the severe problems she had overcome. She was an achiever and a survivor, and far from holding her back in any way, cannabis use had apparently been critically important in facilitating her reemergence from years of physical, mental, and emotional debility.

Joanie: I broke my leg in a skiing accident when I was 13. They put in a rod, and they had to take out my kneecap to do it.

Dr. M: What kind of pain meds did you use?

Joanie: I was in constant pain, and they put me on Vicodin. It made me sick to my stomach. I was vomiting every day, every time I took it. Celebrex also hurt my stomach.

Dr. M: How did all this affect you mentally?

Joanie: I got depressed, and they put me on antidepressants; Pamelor first, when I was 14. It didn’t work, and every time I saw a doctor they were trying a new antidepressant medication, or changing the dose. I can’t tell how many antidepressants I tried. None of them worked, they all made me worse. They didn’t know what to label me; bipolar, or whatever. They had me on antipsychotic drugs, which also made me worse.

When I was 15 I had another surgery, because the rod in my leg had got stuck as I grew, and caused nerve damage. The pain was constant, and the next drug I tried was Darvocet. I took that for a year, and it gave me terrible rebound headaches. I had had migraines since I was 13, and the Darvocet made them way worse.

Then, when I was 16, I got rear-ended by a big truck while I was waiting to make a left turn. The whole back of my car was crunched right up, practically to the back of my head. I had a whiplash injury. When they did the MRI of my spine, they discovered I had scoliosis.

Dr. M: How and when did you discover cannabis?

Joanie: I tried it at school with friends, when I was 15.

Dr. M: Recreationally, or did you think it might help with the pain?

Joanie: I knew it was legal medically in California, but I was just trying it with friends. But I could tell instantly that it made me feel a lot better: it took my mind off the pain, and made me less depressed.

Dr. M: And did you start using regularly right away?

Joanie: No, only occasionally, for the next few years. I would get it from friends a couple times every week.

Dr. M: What happened with school during those years?

Joanie: Well, l could have done better if I hadn’t been so depressed and in so much pain. The fluorescent lights gave me a headache every day, so I had really poor attendance. For a two-year period I never made it to a full week of school because of the headaches and medication side effects. Finally, I sort of gave up on the kind of academic pre-college program I had been working on, and went to culinary school at the Skills Center. I couldn’t do school work or study, but I figured it was okay to be in the kitchen.

Dr. M: How did that work out?

Joanie: Not too well. The teachers were sending me to the office all the time because of the way the antidepressants and antipsychotics were making me act. They thought I was on drugs, which I was.

Dr. M: So, when did you start using cannabis regularly?

Joanie: When I was 18.

Dr. M: And how has that helped?

Joanie: Well, you could call it a complete turnaround, I guess. First, I figured out that what I had been getting from my friends was not good quality, so when it became legal and I got my card I started growing my own much, much better stuff. I smoke it every day—my vaporizer broke—and I’m back in school. I have a double major now, in French and Linguistics. I have a 3.88 GPA in my junior year, and am doing very well, thanks to the cannabis. I also make an arthritis balm with olive oil and beeswax, and put it on my knees and my back.

Dr. M: Do you still take any prescription medications?

Joanie: I take Fiorcet, because the lights at school still give me headaches. Fiorcet takes the pain down to where I can function, and when I get home in the evening, the cannabis takes it away completely. I’m off the antidepressants and psych drugs completely.

Dr. M: What is your parents’ attitude towards your use of cannabis?

Joanie: Oh, totally supportive. My father is a builder, and he has back pain. We smoke together. My mother gets too spaced out from it, so she just uses the topical butter for her back pain. They are both just very happy to know that I am doing better, and functioning again, after seeing me on so many pills for years, and not wanting to get out of bed. Even my grandma is so happy to see me back in school. But she doesn’t know about the pot!

Dr. M: Do you have many friends who medicate too?

Joanie: Not too many. There have been so many raids around here lately that I keep pretty quiet. But I keep in touch with a few people about their grows, and different strains we try out.

Jack: Pediatric Diabetes and ADHD

Jack is a seven-year-old boy with type-I diabetes and ADHD who was brought to the clinic one recent afternoon by his mother. Michigan requires two physician certification signatures for children under 18. The family had already gotten one from another doctor —not one of Jack’s personal physicians—so it was my call about his card.

I had previously certified one kid this young (see next case). But I had encountered dozens of older patients who had been helped by cannabis with their attention deficit problems. ADD is not a qualifying condition in Michigan, so my learning about this benefit was often accidental, especially if a patient had been able to drop his Ritalin or other stimulant once on cannabis. I felt that I had a solid base of clinical experience to support that many people with ADD and ADHD did indeed get a real benefit from cannabis.

My mental trump card was the YouTube video that I had gone back to view repeatedly of the late Claudia Jensen, MD, being interviewed by Keith Olberman. Jensen’s patients included teenagers who had used cannabis for ADD with dramatic success. She said the reason she had become an enthusiast for cannabis therapy was that she listened to what her patients had to tell her.

Jack was a blond kid, small for his age, and on his best behavior for the visit. His mother, Laura, provided clear documentation of his problems: ADHD as well as type I diabetes, with nausea (which is a qualifying condition). She said he was having significant behavior issues in school as well as at home.

“In for a dime, in for a dollar,” I was thinking as I signed the cert paper.

I called Laura about six weeks later for a progress report.

Laura: Well, he’s not having any more trouble in school, and he has a much better attitude at home. The teachers have all noticed the difference, and say he is paying much better attention now. Before the medicine change, we were getting calls every day, and he was being kicked out of school all the time. They said he was talking back, and always arguing with everybody. I’m still calling someone at school almost every day, and they are very positive. It had been iffy about Jack passing this grade, but now it looks like he will advance for sure.

Dr. M: How about his written work?

Laura: Well, now I now can read his writing, whereas before it was mostly scribbles. And his spelling, which was not even remotely close to correct, is better. His work is actually better than his older sister’s now, which has never been the case.

Dr. M: Tell me about his medicine.

Laura: We are making “medibles” for him, in the morning before school, and in the evening. He gets a little drop of the Simpson oil, that I scoop up with a toothpick. It’s about the size of one of those large pinheads. He takes it with peanut butter, and generally doesn’t notice the taste.

Dr. M: Where did you get the idea for Simpson oil?

Laura: From the Run from the Cure videos on the internet.

Dr. M: Did somebody treat for ADD in that video?

Laura: No, for diabetes. Several people had improvements.

Dr. M: So your original idea was to treat Jack’s nausea from the diabetes, not so much the ADHD?

Laura: That’s right.

Dr. M: Has there been any change in his sugars?

Laura: Yes, a big change. He is testing now even lower than his target, which is 200. He has been in the low hundreds, and sometimes lower. Before the cannabis, he was in the two- and three-hundreds.

[Cannabis has been shown to reduce inflammation in the pancreas, and improve control of blood sugar. Sugars in the low one-hundreds in a type-one diabetic would indicate very good control.]

Dr. M: Wow! That’s remarkable.When does he see the endocrinologist again, and what are you going to tell him?.

Laura: Next month. The sugar readings are all there in his meter. We’ll cross that bridge when we come to it.

Dr. M: What strain of pot is he getting?

Laura: White Widow.

Dr. M: How about the pediatrician who prescribed the Ritalin?

Laura: I think I can level with him. We don’t have a scheduled appointment, we just go in when there is a problem.

Dr. M: Wasn’t he getting some benefit from Ritalin?

Laura: No, he was not controlled at all. That medicine did nothing for him and even made him worse, in every possible way. He was always complaining that it made his stomach hurt, but he took it anyway because he knew it was supposed to help him. But it didn’t. Plus, he had zero appetite. He could never gain weight. We had to try to force foods into him. Now he is gaining weight and asking for seconds. The new clothing I bought for him just after Christmas, three months ago, is all too small now.

Dr. M: What about at home? How is Jack feeling about himself and this new medicine?

Laura: He is happier, and very much aware that this medicine is helping him. He goes to bed with no hassle. He’s even reading to me from a book, where it used to be a battle to get him to just lie down. And getting up in the morning is no longer the struggle it was. Oh, and his headaches are gone now. He was having them two or three times per week, coming home from school and having to sleep for hours.

Dr. M: I want to keep in touch, and see you in the office in a month or so. Is there anything else you want to add?

Laura: Yes. After one week on the cannabis, Jack said to me, “Mom, I want to flush those old pills down the toilet.”

So that’s just what we did.

Nikki: Brain Cancer

Nikki was the first child patient I certified. I saw her in April of 2009, soon after she finished more than a year of chemotherapy for a brain tumor.

Nikki was bony, blond, with thin, fly-away hair. She was a little distracted, but smiling appropriately. Her left eye didn’t track properly. Her mother did most of the talking about her history.

Jane: The problem started in January of 2008. I went to wake her up one morning when she was three years old, and she looked like somebody who’d had a stroke; wasn’t using her left side, and her face was drooping. We called the ambulance, and at the hospital they did a CT scan, and sent her straight to the university in Ann Arbor. They did more scans there, and found the tumor. It was too big to remove completely, so four days later they did a debulking surgery, and she started the chemo in February. She went four weeks on and two weeks off all year, and just finished recently. It was carboplatin and vincristine originally, but she went totally blind for three weeks, so they stopped the vincristine. She’s still blind on the left.

Dr. M: How did she tolerate the chemo?

Jane: It made her sick some days, but not deathly ill. She was always tired, and passed out once at a session. After that they let her quit early.

Dr. M: And what about the behavior problems?

Jane: Well I think the root of it all was that she couldn’t sleep. She would go days without sleeping, and then just crash wherever she was, always for four hours. Then she’d wake up, and the whole thing would start all over again. We had her grandparents staying over some nights so her father and I could get some sleep. “I can’t sleep, Mom,” she’d tell me. I think that was 90 percent of the problem. She was just miserable and mad at the world, because she was so tired all the time.

Dr. M: What kind of behavior problems were there?

Jane: She became really angry, and wouldn’t share anything with other kids. She didn’t want to play with them, or even be around the dogs and cats. She would scream at her sister, “Leave me alone,” and “Get out of my room.” She lost her appetite, and would tell us she wasn’t hungry when we tried to get her to eat. She also had a hypersensitivity to noise, and couldn’t stand the radio in the car when we went out.

Dr. M: What about school?

Jane: We tried kindergarten, but she puked on the third day, and with the way she was acting, the principal said she wasn’t ready for school, so we pulled her out.

Dr. M: How has her use of cannabis changed things?

Jane: Well, basically she’s a happy little girl again. She’s back in school and has lots of friends. She’s big into hugs, hugs everybody now.

Dr. M: Tell us about the way you use the medicine

Jane: She uses the Simpson oil, at bedtime every night. We mix up a quarter teaspoon of the oil into a half cup of peanut butter. I microwave it to soften it up. She gets a half teaspoon of that mix every night, a little before bed. She sleeps from 8:30 at night to 6:30 in the morning, and gets up to go to school, and does fine all day.

Dr. M: Does anybody know she’s using cannabis?

Jane: We haven’t said anything to the teachers. The oncologist knows. His staff told us “Just keep doing what you are doing.” The brain scans have been stable now for a year, with some suggestion on the last one that the tumor may even be shrinking. She got scans every four months for a year, but now she’s going to a six-month schedule. All of her blood work has also been good.

Dr. M: And are there other doctors she sees?

Jane: We don’t see the pediatrician much, because she hasn’t been sick. I don’t know if it’s the oil, but she never gets colds, or sore throats, or earaches. We did not tell the psychologist. We have a home counselor, and she knows, but hasn’t said anything to the psychologist or anybody else. After we started the oil treatment she noticed the improvement immediately. She said, “What have you done with this child? She is so much better!” I was afraid of having complications, and I said “Nothing,” but then I came clean about it the next time she asked. She has been really helpful in keeping it quiet. I am nervous about having problems. My little girl doesn’t need that.

Dr. M: How is Nikki doing in school?

Jane: She is doing really well. She’s in kindergarten, a year behind for her age, but doing well with numbers and letters, and she can write her name. She’s legally blind, but she can read the large print books they have for her. Her behavior is so much better, but if I hold the Simpson oil for even one day, Nikki can’t sleep, and goes back to her same problems. I have tried not giving it several times on weekends, and the sleeplessness and irritability come back right away.